Researchers at Weill Cornell Medicine have discovered that individuals who experience intracranial hemorrhages, or “brain bleeds,” caused by ruptured blood vessels in the brain, face a doubled risk of developing dementia later in life. This groundbreaking study, published on January 30 in Stroke, highlights the need for increased attention to the long-term cognitive impact of hemorrhages, extending prior research on the connection between dementia and ischemic strokes, which are caused by blood clots that block blood flow to the brain.
“We consistently see an elevated risk of dementia, regardless of the type of bleed,” said Dr. Samuel Bruce, the first author of the study, assistant professor of neurology at Weill Cornell Medicine, and neurologist at NewYork-Presbyterian/Weill Cornell Medical Center.
The findings suggest that individuals who have suffered an intracranial hemorrhage should be regularly screened for cognitive impairment, as early identification of dementia could inform future care strategies for these patients and their families.
Dr. Bruce and his team used Medicare insurance claims from 2008 to 2018 to analyze the health records of nearly 15,000 individuals who experienced various types of intracranial hemorrhages, which occur when blood collects in brain tissue or under the skull. While hemorrhages can result from head injuries, the study focused on those that occurred spontaneously. The researchers found that these patients had a two-fold increased risk of receiving a first-ever dementia diagnosis, with an average follow-up period of 5.6 years, compared to more than two million individuals who did not experience a hemorrhage.
These results contribute to existing literature linking hemorrhages to future cognitive decline. For example, a study based on medical records in Denmark showed that 11.5% of individuals who had brain bleeds developed dementia, a 2.5-fold increase compared to the general population. In contrast, ischemic strokes increased the risk of dementia by approximately 1.7-fold.
Dr. Santosh Murthy, senior author and associate professor of neuroscience at the Feil Family Brain & Mind Research Institute, as well as of neurology at Weill Cornell Medicine, explained the possible mechanisms linking hemorrhages to dementia. “Hemorrhages may contribute to dementia by promoting the accumulation of amyloid beta, a protein that disrupts brain function,” he said. Alternatively, the connection may be indirect, with shared risk factors—such as chronic vascular damage—leading to both conditions.
“As we gather more evidence linking dementia with hemorrhages, we must consider the broader implications,” said Dr. Murthy, who is also a neurologist at NewYork-Presbyterian/Weill Cornell Medical Center. “For example, evaluating the safety of anti-amyloid beta treatments for Alzheimer’s disease in individuals with a history of hemorrhages should become a research priority.”
The researchers also emphasized that advancements in treatment for intracranial hemorrhages could potentially extend patients’ lives following such incidents. These improvements would further underscore the importance of routine cognitive screenings for individuals who have experienced brain bleeds.
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